Rationing or priority setting occurs in all health care systems. Doctors, managers, and politicians are involved in making decisions on how to use scarce resources and which groups and patients should receive priority. These decisions may be informed by the results of medical research and cost effectiveness studies but they also involve the use of judgement and experience. Consequently, priority setting involves ethics as well as economics and decisions on who should live and who should die remain controversial and contested.
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Angela Coulter is Director of Policy and Development at the King's Fund in London.
Chris Ham is Professor of health policy and management at the University of Birmingham and Director of the Health Services Management Centre.
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